How much rates vary
Facilitymedian $2,138 · 10th to 90th $794 to $7,586Professionalmedian $1,778 · 10th to 90th $813 to $3,311
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | 78 · Unplanned return to OR | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $891.25 | Professional | None | $794.33 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $616.60 |
BCBS Minnesota Setting Facility Modifier None Typical Low $4,265.80 Median $6,456.54 Typical High $12,302.69 | Facility | None | $4,265.80 | $6,456.54 | $12,302.69 |
BCBS Minnesota Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,659.59 | $2,884.03 |
BCBS Minnesota Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,318.26 Typical High $2,290.87 | Professional | 54 · Surgery only | $977.24 | $1,318.26 | $2,290.87 |
BCBS Minnesota Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $331.13 Typical High $562.34 | Professional | 55 · Aftercare only | $245.47 | $331.13 | $562.34 |
BCBS Minnesota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,412.54 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,412.54 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $3,890.45 | Facility | None | $1,318.26 | $2,041.74 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,513.56 | $2,398.83 | $3,715.35 |
Health Partners Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,174.90 | $1,905.46 | $3,311.31 |
Health Partners Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,348.96 | $2,137.96 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $6,760.83 | Facility | None | $1,412.54 | $2,187.76 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,737.80 Typical High $7,079.46 | Professional | None | $912.01 | $1,737.80 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $8,317.64 | Facility | None | $1,513.56 | $2,511.89 | $8,317.64 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,659.59 Typical High $3,090.30 | Professional | None | $891.25 | $1,659.59 | $3,090.30 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | 53 · Discontinued | $158.49 | $158.49 | $158.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $173.78 | Professional | 53 · Discontinued | $158.49 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $87.10 |
BCBS Minnesota Setting Facility Modifier 50 · Both sides Typical Low $6,456.54 Median $11,481.54 Typical High $21,379.62 | Facility | 50 · Both sides | $6,456.54 | $11,481.54 | $21,379.62 |
BCBS Minnesota Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,511.89 Typical High $4,265.80 | Professional | 50 · Both sides | $1,862.09 | $2,511.89 | $4,265.80 |
Where Minnesota sits
The same service costs 3.2 times more in Oklahoma than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
OK $7,412MD $2,297
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.